Customer case study · Trident Anesthesia
How Trident Anesthesia stopped building call by hand.
Eighteen physicians. Seven hospitals. One partner who used to spend his nights and weekends on the schedule and has not touched the spreadsheet since November 2025.
Before
One partner. Every month. His nights and weekends.
Trident Anesthesia is an eighteen-physician group covering seven hospitals across a region. Before Nice Schedule, one of the partners — Dr. Feller — built the monthly call schedule by hand in a spreadsheet.
That job is not a Saturday afternoon. It is nights and weekends. The reason is not the calendar; it is the interactions. Move one call assignment and three other things break: a post-call coverage hole, a partner pairing the group avoids, a vacation glide path that worsens December. Each fix surfaces the next problem.
The local rules are specific: contract-employee minimums, post-call cardiac coverage, weekend pairings the group avoids. A spreadsheet can hold them as long as one person keeps them in their head. The risk is what happens to the schedule when that person stops being available — or wants a weekend back.
The work, before any schedule was generated
Rule capture, then the solver.
The first weeks were not about software. They were about getting the rules out of one partner’s head and onto paper. We sat down with Dr. Feller and walked through every situation the spreadsheet had been quietly handling for years: which sites need which credentials, which partner pairings get avoided on weekends, what post-call rest looks like after a cardiac case, how contract employees’ committed shifts get protected before partners absorb the rest.
Then we imported the prior months’ schedules so fairness accounting could start from history, not from zero. Then we encoded the rules into the solver as constraints. Then — only then — we generated the first draft schedule.
Contract minimums protected first
Contract employees get their committed shifts first. Partners absorb the remainder. Encoded as a hard constraint — the solver assigns contracts before anything else.
Post-call cardiac recovery
Cardiac call comes with specific post-call rest requirements distinct from the rest of the schedule. Modeled separately, enforced before any cardiac assignment lands.
Weekend partner pairings
Specific partner combinations the group prefers to avoid on weekends. The solver knows which pairs to keep apart and finds combinations that work.
Year-long vacation glide path
Vacation distribution is solved across the whole year. No physician hits December with a backlog of obligations because September got light.
After
Six months of published schedules. The partner has not touched the spreadsheet.
Since November 2025, every monthly Trident call schedule has been built through our solver and delivered to the group. The April 2026 schedule above is one of them. Dr. Feller reviews each draft, locks the assignments that need to stay fixed, and we re-run the rest. The published version goes out to eighteen physicians without a partner spending a weekend on it.
What changed, mechanically, is that the rules now live in the solver instead of in a partner’s head. What changed for Trident is that a partner’s weekends came back.
What it does not solve
The honest part.
A solver does not make the politics disappear. When two partners disagree about a Saturday, the solver shows the tradeoff — it does not resolve it. Somebody still has to make that call.
What it does change is who is doing the combinatorial math. Trident’s solver checks thousands of combinations against their rules every time we run it. Dr. Feller used to do that in his head, every month, on his Sundays.
If your group has a partner doing the same job today and you are wondering whether this would work for you — the honest answer is: it depends on whether your rules are the kind that can be modeled. We will tell you in writing before you commit to anything.
What we built it on
If you want to see the pieces in more depth.
What anesthesia call scheduling actually requires
Post-call rest, site coverage, partner pairings, fairness history — the rules every group has and most tools can’t model. The pillar page.
The AI-plus-solver walkthrough we published for free
The do-it-yourself version of the same approach. ChatGPT plus OR-Tools CP-SAT. Walks through how a constraint solver gets built and what it actually does.
The five-tab template Trident started from
Free .xlsx. Even if you never move to solver-backed scheduling, the structure is the right one.
How we compare to QGenda and Amion
An honest side-by-side. Where each tool is the right answer for an anesthesia group, where it isn’t.
Your group
If a partner in your group is doing Dr. Feller’s job today, send us their hardest rule.
The constraint a generic tool would flatten into a checkbox. The thing that makes the schedule take a weekend instead of an hour. We read every one and reply within one business day. We only take on two new groups per month, so the rule-capture work is done properly.